A case of mesonephric-like adenocarcinoma coexisting seromucinous borderline tumor on the back of endometriotic cyst in the ovary

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  • SUZUKI Yukiko
    Department of Obstetrics and Gynecology, Kobe City Nishi-Kobe Medical Center
  • KOGIKU Ai
    Department of Obstetrics and Gynecology, Kobe City Nishi-Kobe Medical Center
  • NATSUYAMA Takahiro
    Department of Obstetrics and Gynecology, Kobe City Nishi-Kobe Medical Center
  • MORIKAMI Satoko
    Department of Obstetrics and Gynecology, Kobe City Nishi-Kobe Medical Center
  • KONDA Eri
    Department of Obstetrics and Gynecology, Kobe City Nishi-Kobe Medical Center
  • ISHIHARA Misa
    Department of Pathology, Kobe City Nishi-Kobe Medical Center
  • NARITA Moyu
    Department of Gynecologic Oncology, Hyogo Cancer Center

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Other Title
  • 卵巣に子宮内膜症性囊胞を背景として中腎様腺癌と漿液粘液性境界悪性腫瘍が併存した1例
  • ランソウ ニ シキュウ ナイマクショウセイノウホウ オ ハイケイ ト シテ チュウジンヨウセンガン ト ショウエキ ネンエキセイ キョウカイ アクセイ シュヨウ ガ ヘイソン シタ 1レイ

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Mesonephric carcinomas (MC) are rare malignant tumors in the mesonephric remnant of the uterine cervix. Recently, mesonephric-like adenocarcinomas (MLA), which share similar characteristics with MCs, have been classified in the 5th edition of WHO Classification of Tumors. The exact origin of MLA remains unclear, as they may either arise from the mesonephric tissue or represent Müllerian tumors that closely resemble MC. In this study, we present the case of a 28-year-old pregnant woman with an ovarian cyst. While we could not dismiss the possibility of malignancy, our primary suspicion was that the tumor was an endometriotic cyst exhibiting decidualization based on the MRI image. Following consultation, we made the decision to carefully proceed with the pregnancy without resorting to surgery. During the caesarian section, we performed an ovarian cystectomy, revealing that the cyst was, in fact, an MLA coexisting with seromucinous borderline tumors located on the posterior aspect of the endometriotic cyst. This particular case provides further evidence supporting the notion that MLA represents a Müllerian adenocarcinoma demonstrating mesonephric differentiation. Differentiating between a malignant tumor and an endometriotic cyst with decidualization, during the gestational period poses a challenge. Moreover, the coexistence of MLA and seromucinous borderline tumors likely contributed to the difficulty in distinguishing between benign and malignant conditions. 〔Adv Obstet Gynecol, 76(1): 1-7, 2024(R6.2)〕

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